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View Diary: Pandemic Flu Preparation and the Role of Internet Communities (91 comments)

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  •  Single biggest requirement is ventilators. (1+ / 0-)
    Recommended by:
    Runs With Scissors

    The killer in regard to flu is need for breathing assistance in serious cases.  Only way to provide this is via mechanical ventilators which would work in the home or hospital.

    These cost roughly $2,000, maybe $1000 if gov't got involved and mass produced single model, not likely in this age of "privatization" (aka keeping health care expensive for citizens and profitable for corps.)

    All the "disaster prep" in the world is not going deal with the essential issue of need for mechanical ventilators, distribution and training system in case of flu epidemic.

    To gear up with millions of required ventilators would take years so that is not going to happen over the next few years when flu epidemic is likely to hit.

    That being the case, best bet is be an Adventist, Mormon or survivalist and have 6 month food supply to handle disruptions there.  And spring for a ventilator if you don't want to lose a medically fragile family member (kids, elderly, immune compromised).

    Other than that, just take your chances that flu epidemic does not have that big a impact on basic infrastructure, food, fuel deliveries and hospitals have enough ventilators and beds for those that need it.

    •  no need to take your chances (2+ / 0-)
      Recommended by:
      splashy, TheFatLadySings

      you can do something about it without being a Mormon. Also, if the next pandemic is not h5n1 (severity cannot be predicted), the vents might not be quite as crucial. See this:

      hospitals' limitations in a pandemic

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Oct 07, 2007 at 06:30:19 AM PDT

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      •  Correct...you could spend $4K and prepare (0+ / 0-)

        by stocking food/fuel and having at least one ventilator available.

        Most people are not likely to do that, most can't afford to do it, most don't even know that is the basic survival requirement to prepare.

        For Homeland Security, best they can do is come up with a triage scheme to keep essential services working with a reduced workforce, water, sewer, electric, food production.  Ability to reallocate labor and resources to essential services.

        On the health care side, we have what we have as far as hospital beds and vents and we take care of as many as we can triaging in favor of kids over elderly.

        •  that's ongoing work, unpleasant though it is (0+ / 0-)

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Oct 07, 2007 at 06:44:03 AM PDT

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          •  Explains lack of vents if that's what you mean. (0+ / 0-)

            The article you referenced referred to the fact that there are not and will not be enough ventilators or trained people to operate them and that triage would need to be used.

            Triage guidelines already exist in hospitals, nursing homes etc. so nothing new there.

            Getting back to "planning" for flu epidemic, if folks want to plan the main issue for them would be interruption of food supplies so stockpile, folks won't be doing that.  Second issue would be having home ventilator since that is the killer aspect and even fewer folks will do that so "planning" for the flu epidemic devoles around triage planning both in basic services and health care settings.

            •  this is a good resource (1+ / 0-)
              Recommended by:
              splashy

              and perhaps something better will be placed here.

              Promising Practices (Out-of-hospital care)

              Strategies of patient care when the traditional system is overwhelmed, including use of alternate site

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Sun Oct 07, 2007 at 08:15:31 AM PDT

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              •  People with flu only need hospital for vents (0+ / 0-)

                So "out of hospital" care is not really an issue.

                The entire problem is centered around two issues.

                1. The life/death issue of not enough vents for a real epidemic. That is what will be killing people.
                1. The infrastructure issue of not enough key service people in power, water, food prod/distribution to keep people supplied.
        •  for creative thinking, see (1+ / 0-)
          Recommended by:
          splashy

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Oct 07, 2007 at 06:46:01 AM PDT

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          •  Nothing "creative" about $3K UPS system (0+ / 0-)

            What you referenced, Xantrex 1500, was not a ventilator but UPS system if the power goes off.

            That would be a cost in addition to the ventilator and not very useful one. Most homes with people on ventilators have standby generators (think $3K) in case the power goes out vs. the very short term battery UPS you referenced.

            Again, basic medical need, at home or in the hospital is the ventilator. There simply are not enough of them for a flu epidemic.

            This is what would need to be addressed to prevent deaths.

            Any civic planning (other than increasing ventilator supplies) at local, state or Federal level has to deal with triage plans for providing basic services.  If the guys at the sewer plant get sick, then the guys manning the snow plows have to be ready to fill in for them...that kind of thing.

            •  oh... (0+ / 0-)

              I did't post an answer (I don't have one), I posted a community example of people trying to figure out what they can do, and where their limits are.  ;-)

              How to use a vent is as important as what to use if you  can get one. See Project Xtreme for JIT training.

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Sun Oct 07, 2007 at 08:01:07 AM PDT

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              •  Hmm...thought "no need take chances" reply (0+ / 0-)

                was an "answer" to problem of vents.

                •  I don't know in all honesty (0+ / 0-)

                  whether home ventilation is practical or possible. So many things could go wrong. But i don't know everything.

                  A pandemic with less severity than the current H5N1 in terms of case fatality rate might not need home vents. And we don't know what the next pandemic will bring but we do know that out-of-hospital care will be needed. Right now, alternative care sites are not planning for vent capability, let alone home vent teaching acquisition and instruction. That may or may not be the right thing to do, but it is what's happening.

                  "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                  by Greg Dworkin on Sun Oct 07, 2007 at 08:54:29 AM PDT

                  [ Parent ]

              •  Please help me out here... (0+ / 0-)

                are we talking about HOME ventilator use? or in augmenting hospital supplies in the event of a pandemic?
                The former seems so fraught with complications that it will almost increase mortality and morbidity--
                While the latter is doable but needs urgent planning now-- with so many hospitals  living on the edge-- the last thing they would like to spend is $1million or so on the 100 or so extra vents they will need and the staff to monitor them.

                Necessity is the argument of tyrants; it is the creed of slaves.-- Wm.Pitt the Younger

                by JeffSCinNY on Sun Oct 07, 2007 at 08:58:43 AM PDT

                [ Parent ]

                •  what I am talking about is (1+ / 0-)
                  Recommended by:
                  JeffSCinNY

                  augmenting hospital supplies in the event of a pandemic. What AzulDias is talking abiout is home ventilation. I just don't see that as practical.

                  "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                  by Greg Dworkin on Sun Oct 07, 2007 at 09:32:45 AM PDT

                  [ Parent ]

                  •  Thanks (1+ / 0-)
                    Recommended by:
                    DemFromCT

                    I think that some funding needs to be committed to purchase these extra ventilators. I don't think it can be done on a hospital by hosptial basis because of the very disparate financial situations of the various hospitals. It could be done city  or state wide and then the vents doled out as needed, but they would have to start buying them NOW..

                    Necessity is the argument of tyrants; it is the creed of slaves.-- Wm.Pitt the Younger

                    by JeffSCinNY on Sun Oct 07, 2007 at 10:23:21 AM PDT

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        •  Homeland Security to work? Work?? You serious? (1+ / 0-)
          Recommended by:
          splashy

          Hoo boy, if I look at the most recent action (??) of Homeland Security, I'm not comforted much at all.  For them, rather than kids over elderly, it would be rich over poor.

          I'm sure that the Bushes have a ventilator/person at their abode--same with Cheneys, and the hell with anyone else.

          I am a retired nurse, and really have not seen much written lately coming from a nursing perspective, altho I must admit that not being in action in nursing does handicap my abilities to obtain info from nursing outlets.

          I guess what I'm saying is that for anything from Homeland Security to work, Chertoff would have to be replaced, and probably all the other cronies would too.  I'm saddened when I think of what used to be the results of FEMA and what is has become under the Bush administration.

          •  by all means, review the previous diaries (0+ / 0-)

            here but remember that buried under Chertoff are some excellent career professionals in FEMA (should be its own agency), HHS and elsewhere trying to do the right thing.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Sun Oct 07, 2007 at 10:48:56 AM PDT

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        •  reply to correct ... $4K (0+ / 0-)

          your last comment...

          we take care of as many as we can triaging in favor of kids over elderly.

          maybe I'm feeling macabre, but I'd hope there'd be some nuance to "favor young over old" -- the young have the majority of their lives ahead of them, true, BUT...  the old are more likely to be a reservoir of drastically needed skills and knowledge that the young might die for lack of shortly after or during an epidemic period ...

    •  ventilator need is minority (1+ / 0-)
      Recommended by:
      DSC on the Plateau

      Realistically speaking, the percentage of people sick enough to need a ventilator will be the minority (not that that's any consolation to them or their families!).

      Many other people will die, however, if they dehydrate from a severe case of the flu and this can be prevented with simple at-home care. Learn how to make an Oral Rehydration Solution (ORS). Wikipedia has a detailed page on ORS describing the UNICEF/WHO work in this area.

      Many of the resources available on the Flu Wiki site include this information.
      I got a recipe from Dr. Michael Greger's book, Bird Flu, which you can read in its entirety at that link. (Free)

      Recipe for Rehydration Solution
      1 quart (or liter) drinking water
      2 Tablespoons of sugar
      1/4 teaspoon of table salt
      1/4 teaspoon of baking soda
      (1/4 teaspoon of salt substitute, potassium chloride, optional)
      You need to get a cup of this, especially if there is diarrea, or any other liquid down the patient every waking hour, even if you have to use a spoon or dropper.

      If you have this information you can save a life.

      "It is time, brothers and sisters, for America to be patriotic about something other than war." John Edwards, 1/14/07.

      by sillia on Sun Oct 07, 2007 at 11:28:00 AM PDT

      [ Parent ]

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